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Originalia

Riskanter Alkoholkonsum bei Patienten in ambulanter Psychotherapie

Published Online:February 16, 2012https://doi.org/10.1026/1616-3443/a000120

Abstract

Zusammenfassung.Theoretischer Hintergrund: Bei ca. 20% der deutschen Bevölkerung ist der Alkoholkonsum als riskant einzustufen. Alkoholkonsum birgt Gesundheitsrisiken und beeinflusst emotionale und kognitive Prozesse. Fragestellung: Wie häufig ist riskanter Alkoholkonsum bei ambulanten Psychotherapiepatienten? Hängt er mit Diagnosen und Symptomen der Patienten zusammen und beeinflusst er die Wirksamkeit der Psychotherapie? Methode: Bei 254 ambulanten Psychotherapiepatienten mit affektiver- oder Angststörung wurden Prädiktoren riskanten Konsums ermittelt. Konsumstabilität und die Auswirkungen auf den Therapieprozess wurden bei N = 183 Personen untersucht. Ergebnisse: Ca. jeder vierte Psychotherapiepatient konsumierte riskante Mengen von Alkohol. Prädiktoren waren Geschlecht, Komorbidität und Ausgangsbelastung in der SCL-90-R. Ein negativer Einfluss auf das Therapieergebnis wurde nur bei depressiven Männern festgestellt. Nur ca. 1/3 der Patienten reduziert den Alkoholkonsum im Verlauf der Therapie. Schlussfolgerungen: Riskanter Alkoholkonsum ist bei Psychotherapiepatienten kaum häufiger als in der Allgemeinbevölkerung. Ohne alkoholspezifische Kurzinterventionen bleibt der Alkoholkonsum mehrheitlich unverändert.


Risky alcohol consumption in patients in outpatient psychotherapy

Abstract.Background: About 20% of the German population consume alcohol in a hazardous manner. Hazardous alcohol consumption enhances the risk of health problems and influences emotional and cognitive processing. Objective: To report psychotherapy outpatients’ prevalence of hazardous alcohol consumption, and to identify its predictors and consequences for the efficacy of psychotherapy. Methods: Prevalence and predictors of hazardous alcohol use were determined in 254 outpatients with affective or anxiety disorders. Steadiness of alcohol consumption and its consequences for therapy were analyzed (N = 183). Results: Every fourth outpatient showed a hazardous drinking pattern. Predictors were gender, comorbidity, and severity of overall symptoms. A negative influence on the result of the psychotherapy was only found for men with depression. Only about one third of the patients had reduced their alcohol consumption at the end of treatment. Conclusions: Prevalence of hazardous drinking patterns in psychotherapeutic outpatients does not seem to be higher than in the general German population. Hazardous alcohol consumption is mostly not reduced in the course of treatment without specific interventions.

Literatur

  • Agabio, R. , Marras, P. , Gessa, G. L. , Capriniello, B. (2007). Alcohol use disorders, and at-risk drinking in patients affected by a mood disorder, in Cagliari, Italy: Sensitivity and specificity of different questionnaires. Alcohol & Alcoholism, 42 (6), 575–581. First citation in articleCrossref, Google Scholar

  • Augustin, R. , Kraus, L. (2005). Alkoholkonsum, alkoholbezogene Probleme und Trend. Ergebnisse des Epidemiologischen Suchtsurvey 2003. SUCHT, 51 (Sonderheft 1), 29–39. First citation in articleLink, Google Scholar

  • Babor, T. F. , Higgins-Biddle, J. C. , Saunders, J. B. & Monteiro, M. G. (2001). AUDIT. The alcohol use disorders identification test. Guidelines for use in primary care (2nd ed.). World Health Organization, Geneva. First citation in articleGoogle Scholar

  • Buckner, J. D. , Schmidt, N. B. , Lang, A. R. , Small, J. W. , Schlauch, R. C. , Lewinsohn, P. M. (2008). Specificity of social anxiety disorder as a risk factor for alcohol and cannabis dependence. Journal of Psychiatric Research, 42, 230–239. First citation in articleCrossref, Google Scholar

  • Dilling, H. , Freyberger, H. J. (2008). Taschenführer zur ICD-10 Klassifikation psychischer Störungen (4., überarbeitete Aufl.). Bern: Hans Huber. First citation in articleGoogle Scholar

  • Edwards, G. , Arif, A. , Hodgson, R. (1981). Nomenclature and classification of drug- and alcohol-related problems: A WHO Memorandum. Bulletin of the World Health Organization, 59 (2), 225–242. First citation in articleGoogle Scholar

  • Franke, G. H. (2002). SCL-90-R. Die Symptomcheckliste von Derogatis – Deutsche Version – Manual (2. Auflage). Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Gache, P. , Michaud, P. , Landry, U. , Accietto, C. , Arfaoui, S. , Wenger, O. , Daeppen, J. B. (2005). The Alcohol Use Disorders Identification Test (AUDIT) as a screening tool for excessive drinking in primary care: reliability and validity of a French Version. Alcoholism: Clinical and Experimental Research, 29, 2001–2007. First citation in articleCrossref, Google Scholar

  • Grant, B. F. , Stinson, F. S. , Dawson, D. A. , Chou, S. P. , Dufour, M. C. , Compton, W. et al. (2004). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: Results from the national epidemiologic survey on alcohol and related conditions. Archives of General Psychiatry, 61, 807–816. First citation in articleCrossref, Google Scholar

  • Gual, A. , Segura, L. , Contel, M. , Heather, N. & Colom, J. (2002). AUDIT- 3 and AUDIT-4: Effectiveness of two short forms of the Alcohol Use Disorders Identification Test. Alcohol & Alcoholism, 37 (6), 591–596. First citation in articleCrossref, Google Scholar

  • Haynes, J. C. , Farrell, M. , Singleton, N. , Meltzer, H. , Arays, R. , Lewis, G. & Wiles, N. J. (2008). Alcohol consumption as a risk factor for non-recovery from common mental disorder: results from the longitudinal follow-up of the National Psychiatric Morbidity Survey. Psychological Medicine, 38, 451–455. First citation in articleCrossref, Google Scholar

  • Hautzinger, M. , Bailer, M. , Worall, H. , Keller, F. (1995). Beck-Depressions-Inventar (BDI) – Manual (2. Auflage). Bern: Hans Huber. First citation in articleGoogle Scholar

  • Hiller, W. , Schindler, A. , Andor, T. , Rist, F. (2011). Vorschläge zur Evaluation regulärer Psychotherapie an Hochschulambulanzen im Sinne der Phase-IV-Therapieforschung. Zeitschrift für Klinische Psychologie und Psychotherapie, 40 (1), 22–32. First citation in articleLink, Google Scholar

  • Jung, J. (Hrsg.). (2001). Alcohol and Other Drugs – A Research Perspective. California: Sage Publications. First citation in articleGoogle Scholar

  • Kraus, L. , Augustin, R. (2001). Repräsentativerhebung zum Gebrauch psychoaktiver Substanzen bei Erwachsenen in Deutschland 2000. SUCHT, 47 (Sonderheft 1), 3–86. First citation in articleLink, Google Scholar

  • Kraus, L. , Piontek, D. , Pabst, A. , Bühringer, G. (2011). Alkoholkonsum und alkoholbezogene Mortalität, Morbidität, soziale Probleme und Folgekosten in Deutschland. SUCHT, 57 (2), 119–129. First citation in articleLink, Google Scholar

  • Mathew, A. R. , Norton, P. J. , Zvolensky, M. J. , Buckner, J. D. & Smits, J. A. J. (2011). Smoking behavior and alcohol consumption in individuals with panic attacks. Journal of Cognitive Psychotherapy: An International Quarterly, 25 (1), 61–70. First citation in articleCrossref, Google Scholar

  • Mertens, J. R. , Weisner, C. , Ray, G. T. , Fireman, B. & Walsh, K. (2005). Hazardous drinkers and drug users in HMO primary care: Prevalence, medical conditions, and costs. Alcoholism: Clinical and Experimental Research, 29 (6), 989–998. First citation in articleCrossref, Google Scholar

  • Pabst, A. , Kraus, L. (2008). Alkoholkonsum, alkoholbezogene Störungen und Trends. Ergebnisse des Epidemiologischen Suchtsurveys 2006. SUCHT, 54 (Sonderheft 1), 36–46. First citation in articleLink, Google Scholar

  • Pabst, A. , Piontek, D. , Kraus, L. , Müller, S. (2010). Substanzkonsum und substanzbezogene Störungen. Ergebnisse des Epidemiologischen Suchtsurveys 2009. SUCHT, 56 (5), 327–336. First citation in articleLink, Google Scholar

  • Reinert, D. F. , Allen, J. P. (2007). The Alcohol Use Disorder Identification Test: An update of research findings. Alcoholism: Clinical and Experimental Research, 31 (2), 185–199. First citation in articleCrossref, Google Scholar

  • Rist, F. , Demmel, R. , Hapke, U. , Kremer, G. , Rumpf, H.-J. (2004). Riskanter, schädlicher und abhängiger Alkoholkonsum: Screening, Diagnostik, Kurzintervention. Leitlinien der AWMF. SUCHT, 50 (2), 102–112. First citation in articleLink, Google Scholar

  • Rist, F. , Glöckner-Rist, A. , Demmel, R. (2009). The Alcohol Use Disorders Identification Test revisited: Establishing its structure using nonlinear factor analysis and identifying subgroups of respondents using latent class factor analysis. Drug and Alcohol Dependence, 100 (1–2), 71–82. First citation in articleCrossref, Google Scholar

  • Rist, F. , Scheuren, B. , Demmel, R. , Hagen, J. , Aulhorn, I. (2003). Der Münsteraner Alcohol Use Disorders Identification Test (AUDIT-G-M). In A. Glöckner-Rist, H. Küfner (Eds.), Elektronisches Handbuch zu Erhebungsinstrumenten im Suchtbereich. Version 3.00. Mannheim: Zentrum für Umfragen, Methoden und Analysen e.V. First citation in articleGoogle Scholar

  • Robinson, J. , Sareen, J. , Cox, B. J. , Bolton J. (2009). Self-medication of anxiety disorders with alcohol and drugs: Results from a nationally representative sample. Journal of Anxiety Disorders, 23, 38–45. First citation in articleCrossref, Google Scholar

  • Rumpf, H.-J. , Hapke, U. , Meyer, C. , John, U. (2002). Screening for alcohol use disorders and at-risk drinking in the general population: Psychometric performance of three questionnaires. Alcohol & Alcoholism, 37 (3), 261–268. First citation in articleCrossref, Google Scholar

  • Saunders, J. B. , Aasland, O. G. , Babor, T. F. , De La Fuente, J. R. , Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction, 88, 791–804. First citation in articleCrossref, Google Scholar

  • Saunders, J. B. , Lee, N. K. (2000). Hazardous alcohol use: Its delineation as a subtreshold disorder, and approaches to its diagnosis and management. Comprehensive Psychiatry, 41 (2, Sonderheft 1), 95–103. First citation in articleCrossref, Google Scholar

  • Schäufele, M. (2009). Riskanter Alkoholkonsum im höheren Alter: Häufigkeit und Folgen – ein Überblick. SUCHT, 55 (5), 266–280. First citation in articleLink, Google Scholar

  • Seitz, H. K. (2000). Wie viel Alkohol macht krank? Deutsches Ärzteblatt, 97 (22), 1538–1541. First citation in articleGoogle Scholar

  • Shankman, S. A. , Lewinsohn, P. M. , Klein, D. N. , Small, J. W. , Seeley, J. R. , Altman, S. E. (2009). Subtreshold conditions as precursors for full syndrome disorders: A 15-year longitudinal study of multiple diagnostic classes. The Journal of Child Psychology and Psychiatry, 50 (12), 1485–1494. First citation in articleCrossref, Google Scholar

  • Stevens, S. , Rist, F. , Gerlach, A. L. (2008). Ein Überblick über experimentelle Befunde zur Wirkung von Alkohol auf klinisch relevante Angst. Zeitschrift für Klinische Psychologie und Psychotherapie, 37 (2), 95–102. First citation in articleLink, Google Scholar

  • Sullivan, L. E. , Fiellin, D. A. , O’Connor, P. G. (2005). The prevalence and impact of alcohol problems in major depression: A systematic review. The American Journal of Medicine, 118, 330–341. First citation in articleCrossref, Google Scholar

  • Terlecki, M. A. , Buckner, J. D. , Larimer, M. E. , Copeland, A. L. (2011). The role of social anxiety in a brief alcohol intervention for heavy-drinking college students. Journal of Cognitive Psychotherapy: An International Quarterly, 25 (1), 7–21. First citation in articleCrossref, Google Scholar

  • Wittchen, H.-U. , Zaudig, M. , Fydrich, T. (1997). Strukturiertes Klinisches Interview für DSM-IV. Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Zimmermann, P. , Wittchen, H.-U. , Höfler, M. , Pfister, H. , Kessler, R. C. & Lieb, R. (2003). Primary anxiety disorders and the development of subsequent alcohol use disorders: A 4-year community study of adolescents and young adults. Psychological Medicine, 33, 1211–1222. First citation in articleCrossref, Google Scholar